World Neurosurg
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Case Reports
Modified Orbitozygomatic Craniotomy for Clipping of a Ruptured Thrombotic A1-A2 Aneurysm.
Ruptured thrombotic aneurysms pose a dual challenge of subarachnoid hemorrhage and local mass effect on neurovascular structures causing cranial nerve palsies or other neurologic symptoms. Although many thrombotic aneurysms can be treated with endovascular techniques, the benefit of surgical treatment of these aneurysms is the fact that clipping can be followed by removal of the clot and decompression of the contents of the aneurysm sac, thereby relieving local mass effect. In Video 1 we present the case of a young man with a ruptured thrombotic anterior cerebral artery (first segment of anterior cerebral artery-second segment of anterior cerebral artery) aneurysm who presented with bilateral vision loss. ⋯ The patient remained blind in the right eye after the operation, likely due to the initial subarachnoid hemorrhage being directed into the optic nerve. He did, however, have improvement of vision in his left eye. Microsurgical clipping of thrombotic aneurysms allows for exclusion of the aneurysm from the circulation, thereby protecting the patient from repeated hemorrhage, and simultaneous decompression of the local mass effect caused by the rapid increase in the size of the aneurysm due to the clot burden.
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An intracranial solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm with a high predisposition toward recurrence and metastasis. The definition of SFT was updated according to the 2021 World Health Organization (WHO) classification. Given its rarity and resemblance to meningiomas, SFT is often misdiagnosed and there remains a debate on the treatment for it. We provide a retrospective analysis of SFTs and conclude the outcomes of different treatments. ⋯ GTR and postoperative RT are beneficial for preventing tumor recurrence. Larger studies and long-term follow-up are warranted to further identify the effect of postoperative RT.
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This study explored medication errors in the perioperative care of patients with epilepsy and developed consensus-based recommendations to prevent/minimize these errors. ⋯ The findings of this study are informative to decision-makers in health care facilities and other stakeholders in health regulatory authorities who need to design measures to prevent/minimize medication errors and improve perioperative outcomes of patients with epilepsy. Studies are needed to investigate if these recommendations can be effective in preventing/reducing medication errors in the perioperative care of patients with epilepsy.